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Inadvertent cannulation of vertebral artery while central venous catheterization
Punción y canalización accidental de arteria vertebral durante colocación ecoguiada de catéter venoso central
R.C. Vela Pascual
, A.G. Pizarro Calderón, G. Sánchez Barbé, S. García Ramos
Corresponding author
Anestesiología y Reanimación, Hospital Gregorio Marañón, Madrid, Spain
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Vela Pascual, A.G. Pizarro Calderón, G. Sánchez Barbé, S. García Ramos" "autores" => array:4 [ 0 => array:4 [ "nombre" => "R.C." "apellidos" => "Vela Pascual" "email" => array:1 [ 0 => "raquelcarolina.vela@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A.G." "apellidos" => "Pizarro Calderón" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Sánchez Barbé" ] 3 => array:2 [ "nombre" => "S." 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The CVC (red arrow) crosses the left IJV and accesses the left vertebral artery, with the distal end in the ascending aorta, with no other signs of complications.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 79-year-old man with a history of stage IV rectal cancer underwent emergency surgery due to intestinal obstruction and ischaemia. At the end of the surgery in the operating room, a central venous catheter (CVC) was placed for parenteral nutrition.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Using ultrasound, an out-of-plane puncture of the left internal jugular vein (IJV) was performed. Entry into the vein and aspiration of blood were observed. Upon removing the syringe, non-pulsatile, dark-coloured blood flow was noted. The guidewire was then introduced through the needle without resistance. The location in the IJV was verified using ultrasound, although without tracking its entire course. The catheter was then advanced over the guidewire after dilating the tract and subsequently fixed to the skin. Extubation was performed without incidents and the patient was transferred in a stable condition to the Intensive Care Unit (ICU).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Upon admission to ICU, a blood pressure curve was obtained during the measurement of central venous pressure. Suspecting an arterial cannulation, an urgent CT scan was requested (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). 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